Clinical spectrum of infections due to Propionibacterium acnes

Non-purulent low-grade infection as cause of pain following shoulder surgery: preliminary results

“…Infections with P. acnes such as endocarditis, meningitis, brain abscess, septic arthritis, osteomyelitis and implantrelated infections have been described [11,13,[18][19][20][21][22][23][24][25][26][27][28][29]. At the shoulder, several studies reported P. acnes infections, most of them with the typical symptoms of infection such as wound erythema, purulent drainage or chronic sinus tracts as well as systemic symptoms such as fever and elevated Creactive protein levels [1,2,6,8].…”

“…Before index surgery, the patients had an average of two (one to five) prior procedures including open or arthroscopic rotator cuff repairs (6), acromioplasties (6), open reduction and internal fixation (1), stabilisation (1) or other procedures (6). The mean duration between the first prior operation and the index procedure was 10 months (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). The index procedures with harvesting of tissue samples were arthroscopic acromioplasties in five cases, arthroscopic capsulotomies in four cases, and open debridement and bone anchor removal in one case.…”

Acute dehiscence of a valve prosthesis 5 years after implantation

“…Some reports describe endocarditis in patients after receiving contaminated blood [8]. The clinical presentation of these patients vary, the majority has non-specific symptoms like fever, dyspnoea without peripheral stigmata of endocarditis [2,7].…”

“…Only a few cases have been reported in the literature on the occurrence of endocarditis caused by P. acnes [7]. Some reports describe endocarditis in patients after receiving contaminated blood [8].…”

“…In here lies the explanation for the false negative results on blood and tissue cultures. Difficult isolation and tendency to under estimate its clinical significance may lead to delayed diagnosis [7].…”